Presenter: Marissa Hansen, Master of Social Work (MSW), Doctorate in Social Work (in progress, PhD ’09)
Discussant/Mentor: Barry Lebowitz, PhD, UCSD
Sociocultural influences on mental health service use by Latino older adults: Exploring the mediating and moderating role of social support
Authors: Marissa Hansen, MSW and Maria P. Aranda, PhD
Background:
Drawing from the Behavioral Model of Health Care Service Use, the study investigated the influence of social support and sociocultural constructs on mental health service use by low-income Latino older adults. The article addressed conflicting reports in the literature on the function of support as a mediator and moderator in service use. Extending this aim is a comparison of support by type, emotional versus instrumental, while accounting for cultural constructs that include language acculturation and religious orientation. Examining the interrelationships between predisposing and enabling variables estimates social explanations for the underutilization of mental health services by older Latinos.
Method:
Secondary data analysis of a cross-sectional survey of community-dwelling older Latinos, 55-years and older (n=235), was conducted. Path analysis using Poisson regression with Mplus 4.0 software was done to assess mediation and moderation models by type of support.
Results:
Findings revealed significant moderation effects across models. Under conditions of low support, low linguistically acculturated older Latinos used fewer services (p<.05). Small variations by type of support emerged with the emotional support model fitting best with the data. Religious orientation was not significant across the models. Mediation effects were not significant for either dimension of support. Direct effects of language acculturation (p<.05) and age (p<.001) remained after controlling for need (p<.001).
Conclusions:
Findings clarify the function of social support as a moderator in service use when accounting for language acculturation among older Latinos. Limited support was a risk factor for the underutilization of mental health services by low acculturated older Latinos as they increase in age. Integrating support resources that assist in navigating service systems, address language barriers, and provide informational support can enhance service use by Latino older adults. Implications for outreach and screening are discussed to increase mental health service use by socially isolated older Latinos experiencing psychological distress.
